Gui Yu Qu said, “The five elemental phases and the six atmospheric influences have a definite pattern and rhythm. This knowledge is very profound. If one grasps it, one can know the changes that will tran-spire in the natural world. One who masters this sci-ence can enjoy eternal health, one who neglects to learn this will suffer danger, injury and even death by having violated the natural rhythms and patterns of the universe. Please learn, understand, and apply this knowledge carefully.”
Huang Di said, “In order to understand this deeply, one must know its origin and consequences. Then one will know the near and the far. In this fashion, the understanding and application of the five elemental phases and the six atmospheric influences will enable one to achieve clarity. Is it possible for you to summa-rize this in a simple form so that we can more easily understand and recall it?”
Gui Yu Qu answered, “You ask very meaningful ques-tions. The wisdom will become apparent to you very quickly. It is like hitting a drum and hearing the sound;
it is like the echo that results from speaking. It is that transparent; it is that simple.”
Huang Di replied, “This is illuminating. You have com-municated in a specific manner. I will carve it on a jade tablet and preserve it in the Golden Chamber, and I will call it ‘Discussion on the Cosmos.’”1
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“From chaos, Milieus and Rhythms are born. This is the concern of very ancient cosmogonies.”2
1 Maoshing Ni, The Yellow Emperor’s Classic of Medicine: A New Transla-tion of the Neijing Suwen with Commentary (Boston: Shambala, 1995), 2 Gilles Deleuze and Félix Guattari, A Thousand Plateaus: Capitalism 240.
and Schizophrenia, trans. Brian Massumi (Minneapolis: University of Minnesota Press, 1987), 313.
Pulses
…the living thing has an exterior milieu of materials, an inte-rior milieu of composing elements and composed substances, an intermediary milieu of membranes and limits, an
an-nexed milieu of energy sources and actions-perceptions.
–Gilles Deleuze and Félix Guattari1 On the side of my left index finger, over the first knuckle-crease, there’s a small vein. It’s located up from the tiny shard of graphite that broke off when Jim Spagle acciden-tally jammed his pencil into my palm. Our desks were next to each other in second grade. The carbon is lodged deep under the skin, and it’s there for good. Like a fossil.
I’ve developed a habit – a sort of behavioral tic like hair twirling – that I do, usually when I’m avoiding at-tempts to concentrate: with moderate pressure using the base of my thumb, I glide over the little vein, watch it dis-appear, then just as suddenly, it refills with blood. Over and over, I play with the vein with mild amazement. How I can dam up the flow then release it, as a way into my body and its persistent ways. It’s a window into my body’s real-time activities, a glimpse of what is held inside and
1 Gilles Deleuze and Félix Guattari, A Thousand Plateaus: Capitalism and Schizophrenia, trans. Brian Massumi (Minneapolis: University of Minnesota Press, 1987), 313.
the ongoing pressure to sustain movement. I’m reminded of a sea lion that glides towards the thick window of the aquarium tank then makes a sudden U-turn. The blood moving through that small surface vein looks at me then darts down deep to join up with bigger veins on its trip back to my heart for more oxygen.
I’ve also discovered that in the same spot – with light pressure – I can sometimes feel a pulse.
“Every milieu is vibratory,” say Deleuze and Guattari, which suggest that a milieu is a “direction in motion”
that forms a “block of space-time constituted by the peri-odic repetition of the component.”2
“My blood pressure is up. The anesthetist isn’t happy about that.”
My fingers, placed lightly on her wrists, listen to the pulse underneath.
“Surgery’s at the end of month. Be good to finally get the thing out.”
Her question hovers over my head, but my focus re-mains on her pulse. Is it choppy? Or maybe knotted?
“Do you think we can bring my Bp down?”
Blood pressure. The pressure of blood’s push against the walls. Arteries and veins are the vessels that hold blood as their ducts and valves work to help propel blood along their slick, muscled walls. The tremendous push from the heart’s left ventricle begins the circuitous trip. The first big push thrusts oxygenated blood up and out through the thumb-size aorta that makes a hairpin turn down, pushing blood into bifurcating byways and tributaries.
Pressure ensures fresh blood saturates flesh, perfuses or-gans, and gets deep down into bone. Capillary beds are the minuscule sites for gaseous exchanges, trading
oxy-2 Ibid.
gen for waste products, and a venous system trudges it back to the heart and lungs for more fresh oxygen.
Every second or so there’s another thump-push-squirt from the heart’s chamber as blood is propelled through the aorta. Over and over and over the repeated splash, like waves wearing down rocks as blood is pushed through the body.
The metronomic beat quickens with fever, sex, and a fright; or slows with cold, relaxation, or when in deep undisturbed sleep. Veins labor against gravity, pushing – with dogged effort – the blood back towards the heart and lungs. Gravity often wins when valves give up, col-lapsing under time and pressure: varicose veins pop out.
But even as walls thin and erode, the heart insists: “Get up! Keep moving. Life must go on!” Until the aorta, the great garden-hose vessel gets so worn down and stiff from all the incessant forceful splashes that it gives way to a rupture. Or a collective organ mutiny: the kidneys’
filter gives up and toxins seep out; or the brain, so over-taxed and exhausted, also gives up. Enough.
But until then, the pulses keep time.
“Every milieu is coded, a code being defined by periodic repetition,”3 they say.
I press into her wrists. Closer to the bone.
“They said it’s the size of a cantaloupe. With legs com-ing off of it!”
The pulse disappears. Hollow? Hidden?
“Like an octopus,” she adds.
Even in the low light, her face looks pale. Lack-luster.
Lacking luster. Lacking blood, that, if plentiful, creates sheen, a lusty hue to her skin. The presence of the uterine fibroid is causing her menstrual flow to flood, draining her iron stores. Iron in blood carries oxygen, lending
lus-3 Ibid.
ter. Most likely her lips are a shade of purply–cyan under the thick smear of bright-red lipstick.
“Creepy, isn’t it?”
It’s an odd fact: in traditional Chinese medicine, the uter-us, along with the brain and the gall bladder, are consid-ered “curious” organs.
Like playing a double bass, my fingertips jam with the percussive pulse coming from under her wrist. I press and release with my fingertips, moving from spot to spot.
Underneath, the pulse responds, playing a duet with my moving fingers. Forming a line with my fingertips, I break from the duet and press them down in unison. And hold.
I imagine the octopus–fibroid hiding under a rocky ledge.
Listening from the surface, I can feel the vibrations on the sea floor. I track the movements of the fibroid-octo-pus. Above, the waves break, making the water choppy.
Yes, choppy! For a moment, the octopus comes out of hid-ing but with a wild swirl of current, darts back under the ledge.
No, hidden. The wind above the water must be gusty.
Is there such a thing as a gusty pulse?
“…but each code is in a perpetual state of transcoding or transduction,”4 they add for clarity.
Wind, in traditional Chinese medicine, is considered a pernicious influence that can wreak all sorts of havoc.
Someone who suddenly faints or suffers paralysis for no apparent reason is “struck by wind.” Or a gust of wind can be considered “evil wind.” Not that the wind itself in-tends evil, but is, instead, some unknown entity that is carried by the wind.
4 Ibid.
In the form of a lively list, cultural theorist and blog-ger Andrew Murphie lobs an incisive beat between the intervals of the Deleuzoguattarian sonorous and fluctu-ant concept of The Refrain: “In the ocean, for example, the energy of the sun, the forces of current, the nature of water, osmotic membranes, schools of fish, sand and geological formations, etc., all different milieu – as ‘direc-tions in motion’ overlapping and intersecting.” The mul-tiplicities of milieus and rhythms swirl and vibrate in the relational soup, and are “the basic elements from which refrains assemble.”5
Years of circulating Chinese medical theory, planted in my explicit memory as knowledge over three decades ago, perfuses my thinking. As it does, my imploring fin-gers respond to the vibration coming from the surface of her wrists, which are draped across her distended ab-domen. In traditional Chinese medicine, pulse-taking is often the first diagnostic port of call before deciding on which points to needle. Points are selected from a diag-nosis partly informed by what the pulses are indicating.
In the practice of traditional Chinese medicine, theory leads the way.
“And I’m not sleeping,” she adds. “My mind keeps wak-ing me up. Over and over, I can’t quiet it down. Around three a.m., every night.”
Her comment pulls me up from the watery, sensuous depths under my fingers back to heady theory: Three a.m.
is Liver hour on the circadian clock. The Liver circulates the blood. Not enough blood to hold down the qi. So not enough qi to anchor down the yang, which floats up in the middle of the night and Boing! Wide awake. Noise fills her
5 Andrew Murphie, “Milieu, Rhythm, Refrain, Territory,” Adven-tures in Jutland, September 8, 2013, https://web.archive.org/web/
20200530023611/http://www.andrewmurphie.org/blog/?p=426.
head, Heart-blood too weak to fend off the ruminating Spleen. Liver clamors for attention, and succeeds.
The dynamics – the inter-relationships amongst her viscera’s milieu – are out of sync and stuck in a chaotic rhythm. The heart’s milieu – its “direction in motion,” for example – can occasionally throw ectopic or stray beats that are out of sync and might feel chaotic. They are usu-ally clinicusu-ally benign, harmless, but can be unsettling.
Milieus and rhythms – refrains of windy gusts and in-tonations – are making her life miserable, and sending her to the operating theater.
“Meter is dogmatic, but rhythm is critical; it ties together critical moments, or ties itself together in passing from one milieu to another.”6
When learning how to interpret the pulse – again, one of several diagnostic tools in traditional Chinese medicine – different qualities are discerned as fingers are trained to listen to the flow within a person’s body. It is a funda-mental skill in becoming an acupuncturist, particularly if practicing traditional methods. The daunting task re-quires memorizing, and integrating through touch, all of the twenty-six or so different pulse categories with their clinical indications. To be an accomplished practitioner of this ancient traditional approach, an acupuncturist must master all of the pulse categories. Each reflects the qualitative state of the substances (qi, blood, and fluids) that are circulating through the body at that moment in time. Like snapshots of the state of flow in the body, tak-en with knowledgeable and discerning fingertips.
For example, a floating pulse – felt on the surface with only light touch – indicates a superficial pathogen, such as wind and cold that has snuck in and hasn’t (yet) pen-etrated deeper into the body. Whereas a sinking quality
6 Deleuze and Guattari, A Thousand Plateaus, 313.
– a pulse that can be felt only by pressing hard – usually indicates that the illness is located deep in the interior of the body. When the pulse is sinking, commonly referred to as a deep pulse, the body is attempting to deal with a serious problem threatening the viscera. Other qualities – such as soggy (feeling like a thread floating on water) or slippery (like feeling pearls in a basin or beads on a plate) or hollow (like pressing into a scallion stalk) or wiry (like fingers on guitar strings) are among the categories to be memorized and used to form a diagnosis.
A choppy pulse, which comes and goes choppily in jerks, like a knife scraping bamboo, can indicate sluggish blood circulation. Slow moving blood can stagnate, get stuck. A choppy pulse is considered more severe than a knotted pulse. Both indicate degrees of blood stagnation.
Whether knotted or choppy, hidden or hollow, this woman’s blood – from a traditional perspective – is weak and stuck. With a gigantic fibroid obstructing the flow.
“Why can’t I sleep?”
“Because your Chinese Spleen can’t keep your Chinese Heart quiet at night,” I shoot back a chunk of theory as an answer, released from the archives of rote memorization.
She takes in my obscure answer. Ruminates.
“Oh,” she says, in a tone that matches the hollow pulse quality.
More bits of theory float up and circulate in the fore-ground of my thinking, but I shoo them away and return to my listening fingers. I practice a type of mongrel medi-cine that prioritizes pragmatics – led by informed touch – over theory. Go straight to the body, to its unfathoma-ble complexity and continuous state of change, for direct feedback. The sense-perceived field – in the present mo-ment, for the body never stands still – is more important than imposing theoretical chunks of knowledge.
My listening fingers are receiving a quick sense of the atmospheric conditions inside this woman’s body. Pal-pable, vibratory clues to the current state of the living thing’s internal environment: the hum and cadence of relational complexes; forces at play within atmospheric milieus and directions of motion. Which way the wind is blowing. Low-pressure troughs brewing. Shifting jet streams.
Just as I’m about to leave her wrists, another chunk, tucked deep in my dusty archives of Chinese pulse theo-ry, emerges. I recall that a hollow pulse can also feel like touching the surface of a drum, which can not only in-dicate blood loss, but can also occur with hypertension.
Or was it a hidden pulse? Pain can hide the pulse. Pain drives the pulse into hiding. But she’s not in any pain right now. The image of the octopus hiding under a rocky ledge sweeps across my vision. The explicit hollow pulse-chunk recedes back into the theoretical archive.
She persists: “So, do you think you can lower my blood pressure?”
Feeling confident that I’ve captured the general at-mosphere of her body from her pulses, I leave her wrists and the submarine forest of subtle differences – Choppy?
Knotted? Hollow? Hidden? – all wide open to interpreta-tion, and go to her abdomen.
To her hara. Her dantian. Her Sea of Qi. Her body’s ocean floor.
To where my hands listen to the lay of the liquid land – to what is immediately felt – and not cave in to the ten-dency to privilege theory over the pragmatism of direct experience.
I’ve learned to trust my fingers’ implicit knowing as they meet the meeting ground: her body.
“Drying up, death, intrusion have rhythm. It is well known that rhythm is not meter or cadence, even
irregu-lar meter or cadence: there is nothing less rhythmic than a military march.”7
Moving away from pulse poetics, I head towards the crass inelegance of messy, lived experience: to the stuck spot in her soft belly. Straight to the landscape to find a way in to stir the atmosphere with a few carefully placed needles.
Used for several thousand years, acupuncture needles are simple intercessing tools – or tweakers of motion – capa-ble of nudging her blood pressure down by twirling the milieus’ collective direction of motion. And smooth the choppy flow. And coax her Spleen, Liver, and Heart back to more amicable relating for better circulation, and a more peaceful sleep.
“I believe so,” I finally offer back, not quite convincingly.
My left hand investigates the lower left side of her ab-domen; the surface of her body’s seabed. It’s the area, ac-cording to a style of Japanese hara diagnosis, where blood tends to pool and stagnate. Using light pressure with my left middle fingertip, I can feel the top of the fibroid.
I press around the edge of the huge but fairly harmless mass lodged in the muscle tissue of her uterus. There is a sliver of space, a way in.
With my right hand, I reach down to a spot on the top of her left ankle, and press in. It’s a spot, downstream, that is directly related to stuck blood. Related to the area in her abdomen where the cantaloupe–octopus–fibroid lives.
“Is this tender?” Again, I press into the spot.
“A bit.” She winces with the imposed finger pressure.
After holding the spot for several seconds, I recheck the space by the fibroid, pressing in once more. The sliver widens.
7 Ibid.
“The milieus are open to chaos that threatens them with exhaustion or intrusion. Rhythm is the milieus’ answer to chaos. What chaos and rhythm have in common is the in-between – between two milieus, rhythm–chaos or the chaosmos.”8
Swiftly, I tap in a few needles: one into the reactive ankle-spot, two into points on her lower leg, one into the top of her head, and one into the opening space that hugs the side of her octopus–fibroid. Gently twirling each needle, I feel for the trace of a tug, the miniscule sign that the message has been delivered: contact.
Immediately, she drops into parasympathetic bliss.
With the moxa lit, I hold the smoldering pole over the needle that is perched over her fibroid. She’s resting, si-lenced, with her eyes closed. I soon notice a pink hue fill her cheeks. Curious, I place my fingertips on her wrists.
I don’t have to think because the sensation is clear and unmistakable: her pulse is smooth and even.
Calm, open seas.
“Yes. Your blood’s pressure is relieved,” I quietly tell her.
For now.
8 Ibid.
With the deceptive ease of common sense, Whitehead states, simply, “I am experiencing and my body is mine.”9 Whitehead is his experience in its doing, and “the world for me is nothing else than how the functionings of my body present it for my experience.”10 To think with White-head is to recover a common sense that has been lost in the recesses of the binary wedged between mind and body, between reason and intuition.
Of course, we are experiencing and our bodies are ours.
This makes good sense. But the habitual tug of the bi-naries – of splits and bifurcations – is a stubborn and chronic one. The mutual exclusivity of this or that kind of thinking.
How to make a practice of thinking along and amidst the undulating plateaus of plurals? Within the ever-varying manyness of all that comes as one?
How to make a practice of thinking along and amidst the undulating plateaus of plurals? Within the ever-varying manyness of all that comes as one?